Question

1. Unconscious and unidentified man is admitted to an emergency trauma center. What would be the system of choice to ensure patient identification? Explain the three-part method of identification.

2. How would a prothrombin time (PT) result be affected if the tube were only half full? Explain.

3. A patient comes to have a monthly Prothrombin time (PT) collected. You must use a butterfly system because of the patient’s small veins. This is the only test you need to draw. What must you remember to do first?

4. A CBC is collected by fingerstick from a patient. The results of the CBC show a lower WBC and platelet count than blood collected the previous day. What caused this change? Justify your answer.

5. You open a cleaning pad and clean an infant’s heel to do a heel stick and realize that you have just cleaned it with a Betadine solution and not alcohol. What will be the result if a blood sample is collected? Explain.

Answer 1

1) System of choice for identification of unconscious unidentified patient is iris biometric scan “One- to- many identification”(1: N) matching does not require patients to provide an identity credential prior to performing a biometric scan which means that if an unknown,unconscious patient arrives at a hospital their identity can be quickly and accurately determined,even if they can’t speak. Clinicians could gently raise his eyelids,take his picture with an iris camera and instantly determine his identity without requiring any additional information.

2) Prothrombin Time(PT) is a test used to help detect and diagnose a bleeding disorder or excessive clotting disorder,the International normalized ratio ( INR) is calculated from a PT result and is used to monitor how well the blood thinning medication ( anticoagulant) is warfarin is working to prevent blood clots

An Under filled Coagulation Tube Result will show increased clotting times.Coagulation tubes( blue top) are filled with a solution of sodium citrate which acts as an anticoagulant by chelating calcium.Calcium is essential for blood clotting.When Coagulation tests are performed in the laboratory,calcium is added to allow clot formation.Citrate is used as an anticoagulant for clotting tests because it is has a low saturation level and its effects can be reversed by the calcium levels in the clotting reagent.

The tubes have been designed so the ratio of citrate to blood is enough to ensure that all the calcium in the sample has been chelates,thus preventing clotting of the sample,and accurate testing by the laboratory.The tubes have a blood fill tolerance of 10% of the level marked on the label and this is FDA approved.If samples are under- filled,the citrate to blood ratio is too high and therefore,depending on how short,the added calcium will take a time to reverse the citrate effect leading to increased clotting times.

3)When using a butterfly device to draw blood for PT,draw a discard tube first to remove air from the tubing.

4) Finger stick blood tests can deliver inaccurate results of WBC and platelets, due to inadequate sample,it requires at least six to nine drops in order to get consistent results.

5) Betadine contaminated blood may falsely elevate levels of potassium, phosphorus,Utica acid and bilirubin.